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January 9, 2011 @ 8:40 am

Treatments that exist for hair loss


Board Certified Dermatologist Dr. Nicole Rogers with her practrice in Metairie, LA joined the show to discuss hair loss, it causes and treatments that do exist for men and women that are suffering from hair loss.

Note: Refer to audio player below to listen to this episode.


Dr. Nicole Rogers is a board certified dermatologist and fellow of the American Academy of Dermatology. She received her undergraduate degree at Harvard University and her medical degree at Tulane University in New Orleans. Dr. Rogers completed her residency training in dermatology at Tulane where she served as co-chief resident. She took an active role in teaching fellow residents and helped restructure their training program after Hurricane Katrina. During her residency she published several scientific papers including a report that was co-authored with Dr. Farris and published in the journal Pediatric Dermatology. She also won awards through the Women’s Dermatologic Society and American Society of Dermatologic Surgeons to study autoimmune diseases at the University of Pennsylvania and to learn advanced cosmetic techniques in New Haven, Connecticut.

After residency, Dr. Rogers completed a fellowship in hair transplantation and lasers under the direction of Dr. Marc Avram in New York City. Dr. Avram is an internationally recognized expert in the field of hair loss and hair restoration. Together Dr. Avram and Dr. Rogers have written several articles on surgical and medical treatments for hair loss, including contemporary techniques in hair transplantation, minoxidil, finasteride, and the use of low-level-light therapy (LLLT) for hair growth. Dr. Rogers has a passion for treating both men and women with hair loss, using the most up-to-date medical and surgical techniques. Her professional demeanor and specialty training make her an asset to our practice and valued resource for our patients.

Dr. Rogers’ memberships include the International Society of Hair Restoration Surgery, the American Academy of Dermatology, the American Society of Dermatologic Surgery, and Women’s Dermatologic Society.


Edited Transcript of Interview with Dr. Nicole Rogers

Eric Michaels: Tell us about some of the causes of hair loss in men and women.
Dr. Rogers: For most men, hair loss usually results from inherited or genetic factors. They may have had a parent or uncle or even several relatives with hair loss. For women, investigating the cause of hair loss can be a little more tricky. We have to investigate various hormonal factors, such as whether they recently delivered a baby, changed their birth control medication, or had issues with their thyroid. In a young menstruating women, low iron stores can be a contributing factor.  And in a few rare cases, autoimmune conditions such as lupus or scalp infections such as tinea capitis can contribute to hair loss.  We discuss and check all possible causes before commencing any form of treatment. However, even for a large number of women, hair loss can result from genetic factors as well. We call this "female pattern hair loss" and not "male pattern baldness," recognizing that they are 1) not men, and 2) are very unlikely to go bald!  They too, probably had a relative along the lines who suffered from hair thinning. It often presents later in life, after menopause, for women. This is why many people still use the term "androgenetic" alopecia, to describe how hormones and genetics probably both play a role.

Eric Michaels: So what causes genetic hair loss in men and women?
Dr. Rogers: The hair thinning results from a progressive miniaturization process, whereby each time the hair sheds, it is replaced by a hair that is smaller and finer in caliber. This explains how such hair loss can be very gradual in nature and take several years to develop. In men, the hair loss is due to the effects of a chemical called DHT, or dihydrotestosterone on the hair follicle. In women, we still do not know exactly what causes the change but as I said earlier we think the combination of hormones and genetics.

Eric Michaels: What treatments exist for hair loss?
Dr. Rogers: For women, the only FDA-approved treatment for hair loss on the market today is topical minoxidil, or Rogaine. It comes in a 2% solution for women, and they are instructed to apply it twice daily. All patients must allow a full 6 months to see an improvement in the thickness and density of their hair. I like using before and after photos to help document a difference an especially to help motivate my patients. What's the expression, "a watched pot never boils" ? This is especially true when treating hair loss. Patients must be patient and receive as much support and encouragement as possible to stick with the treatment. They should also not panic if they notice some extra shedding in the first 2-4 weeks after they start the medication. This occurs because hairs are shifting into the growth phase and pushing out old hairs. Paradoxically, it is a sign that the drug is working!

Eric Michaels: Is there anyone who should not use topical minoxidil, or Rogaine?
Dr. Rogers: This treatment is not approved for women who are pregnant or breastfeeding. Also a small percentage of people may have a contact allergy to the medicine. This may be to minoxidil itself, or propylene glycol which has been removed in the foam formulation. If this happens, I recommend that patients try to foam (currently only available in a 5%) before they stop the medicine altogether.  Women should not otherwise use the 5% without the consent or supervision or their doctor.

Eric Michaels: Can men use Rogaine? What other treatments exist for men?
Dr. Rogers: Of course! Many men benefit from topical minoxidil. It can have the same effect of increasing the time that hairs are in the anagen, or growth phase, and decreasing the time hairs are in the resting, or telogen phase. Men can benefit from the 5% formulation, and I especially like the foam because it is less greasy and irritating. Propecia, or finasteride is another FDA-approved treatment for hair loss in men. This is a pill taken by mouth, once daily. It has over 10 years of safety data and has been proven to increase hair counts in men and increase hair caliber as well. As with minoxidil, it takes at least 6 months to see a difference. There are no drug interactions, lab monitoring, or allergies reported. Less than 2% of men report a decrease in their libido from the drug. I just encourage patients to inform their internist or urologist because when they have their PSA checked (a marker for prostate cancer), the level should be doubled. This is because Propecia artificially decreases the value of the PSA by half.

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